Anaesthesia fatal in metabolic disorder

A common form of anesthesia, nitrous oxide, may cause serious harm to patients with a rare metabolic disorder, according to a new study. People who are born with certain mutations in the gene responsible for the breakdown of folate may be at risk for neurologic damage and even death, if they are given nitrous oxide.The disorder, known as 5,10-methylenetetrahydrofolate reductase deficiency (MTHFR), is quite rare. It's really important that children with this disorder don't get nitrous oxide. For others, who have the more common mutations, there is no cause for panic. Nitrous oxide has been in use for over 100 years.The researchers from the University of Wisconsin in Madison, re-examined data on the 1983 death of an infant. When the baby was three months old, he underwent anaesthesia to have a leg growth biopsied and later was anaesthetized again to have the leg tumor removed. Though healthy when released from the hospital after surgery, the baby started having seizures and breathing problems 17 days later and died 46 days after surgery. In 1985, when the infant's anesthesiology records were examined, no one knew what caused the child to suffer brain damage which eventually killed him. New research on the disorder pointed to a possible link between the baby's damaged brain and anaesthesia. Nitrous oxide, when given to people with MTHFR, blocks the production of methionine which plays an important role in DNA synthesis of neurotransmitters and myelin, the insulating material covering nerves.Further research on the effects of nitrous oxide on people with the more common mutations, might explain why some people have delayed recovery from surgery.